The goal of this research is the development and implementation of computer-based medical information systems appropriate for the interactive, real-time, multi-user environment of medical care delivery. The purpose of these medical information systems is to facilitate improved patient care, support programs of quality assurance and accountability, and promote cost containment. The strategy we have chosen uses MUMPS (Massachusetts General Hospital Utility Multi-Programming System) for the development of operational information modules, each of which is designed for a specific area of medical information processing and all of which taken together will provide a "total" information system for a medical institution. Modules under active development include an automated medications system for use at MGH, a completely automated medical information/medical record system (COSTAR - Computer-Stored Ambulatory Record) in use for the past seven years at Harvard Community Health Plan in Boston, and a general purpose data management system (MEDINFO). Immediate goals are to: a) improve the designs of existing modules to make them more efficient tools for supporting medical care; b) implement an operational version of the automated medications system; c) develop and implement a generalized version of COSTAR and promote its dissemination; d) continue the enhancement of MUMPS by adding networking and capability and extending the database management capability; and e) promote the transportability of MUMPS Standard and provide application program "packages" in MUMPS Standard.